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Individual

MRS. ANGELA MARIE MITCHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
157 MAYFAIR RD, MOORESVILLE, NC 28117-6022
(859) 630-8893
Mailing address
157 MAYFAIR RD, MOORESVILLE, NC 28117-6022
(859) 630-8893

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004006
KY
225100000X
Physical Therapist
Primary
16981
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004006
KY PT LICENSE
KY
01
16981
NC PT LICENSE
NC
Enumeration date
01/23/2018
Last updated
01/23/2018
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